Skeletal muscles are the ones we use when we decide to move, like lifting our arms or walking. If some of these muscles get damaged, it can lead to a condition called rhabdomyolysis, or just “rhabdo” for short. This happens when muscle cells die and release their contents into the bloodstream, which can cause pain and potentially harm other parts of the body, especially the kidneys.
In the U.S., about 25,000 people get rhabdomyolysis every year. It’s more common in older adults, particularly those over 60. While most people can recover completely with rest and plenty of fluids, more severe cases might require a hospital stay, and some can even lead to fatal complications such as abnormal heart rhythms. That’s why it’s crucial to seek medical attention if you suspect rhabdo.
Common symptoms of rhabdomyolysis include muscle pain, muscle weakness, and dark, reddish urine. However, not everyone experiences all these symptoms, and in some cases, people might not notice any signs at all. The condition can also result in electrolyte imbalances, leading to issues like heart palpitations, seizures, and muscle spasms. Additional symptoms might include fever, rapid heartbeat, and nausea.
Various scenarios can cause muscle breakdown in rhabdomyolysis. Physical trauma is the most frequent trigger, often referred to as “crush syndrome.” Intense physical activity can also be a culprit, especially if someone jumps into a strenuous exercise routine without allowing their muscles to recover between sessions. Certain drugs, genetic diseases, and underlying conditions like muscular dystrophy can contribute as well.
If dehydration is involved, or if someone is exercising vigorously in hot conditions, it can worsen rhabdomyolysis. Healthcare providers typically start by taking your medical history and doing a physical exam to pick up clues. The most definitive test for rhabdomyolysis is checking the level of creatine phosphokinase (CPK) in the blood, which rises significantly when muscles are damaged.
Once diagnosed, the approach to treating rhabdomyolysis depends on severity. Mild cases can often be managed with rest, staying cool, and hydration. More severe cases might require intravenous fluids in a hospital to help flush out muscle cell debris and support kidney function. If complications arise, such as kidney failure, treatments might involve dialysis or other intensive care interventions.
It’s important to pinpoint and remove the cause of rhabdomyolysis when possible, like stopping a medication that’s causing symptoms. Although not every case can be prevented, you can reduce the risk by moderating exercise intensity and staying hydrated, especially in hot weather.
Rhabdomyolysis can cause serious and sometimes life-threatening issues. The kidneys are most commonly affected, potentially leading to acute kidney injury where urine production diminishes. Muscles swelling in their sheaths can lead to compartment syndrome, a serious condition needing immediate intervention to prevent permanent damage. In severe cases, blood clotting abnormalities may develop, particularly if CPK levels are very high, posing a threat to multiple organs and sometimes leading to death.
Most people recover swiftly from rhabdomyolysis with no lasting effects, but 8% to 20% of cases can be fatal. This rate climbs to 50% for those with severe kidney and other organ damage. Most individuals with kidney problems won’t have enduring issues, though a minority might develop chronic kidney disease. Symptoms can appear anytime after the initial muscle injury but may take a few days to become noticeable. Dehydration alone doesn’t cause rhabdomyolysis but can exacerbate it, complicating the body’s ability to eliminate harmful muscle proteins.
